HomeMy WebLinkAboutMortgage_Cochrane'°+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
___._ = FOR DEDUCTION FROM ASSESSED VALUATION
� • State Fortn 43709 (R11 / 6�09)
�'` � P�¢saibed by OepaRment of Laal Govemment Finance
�STRUCTIONS:
To be �led in person w by mad with Ne CountyAUdRw or Counry Recorder ot the counry where the property is located.
Filing Dates: 1) Real Properry: Must file dunrn� the year for whirh the deduclion is sought. ���y n
2) Mo6i7e / Manufactured Homes not assessed as Real PropeRy Mus! file dunng the tweAre (12J r�prYns a
before March 31 of each year the deduction is sought.
See 2verse side lor addi6onal inshucfions arM qualifications. C' ��
/ "h�.rr'i�w���0/ . A'.f-i%��ul m c��hn� GIBSONCOUNTY
�,.�
It ro. whaf a
If nartre m rt
,oer � kgal acsaf
. ����.Z�
6Mimte bebw.
mortgagee or mntraG seAer
of nq�igagce w mnbarl se�er (numDe� end streeG
��Ol�d,sd-
teCness unpaid az of Mortg�,
5 eate c
tt awned wiN u
Name M assi9nee or oRw! wmer or hdder at morigage
AOtlress of assignee (number aM spee4 �Y. sfete, and Z/P code)
Dces appli�ant wm pmperty in any oNa If yes, what munq?
munry in Ind'ona? n Yes ❑ No
What
Counry Auditnr
Caunty Recorder
unpyiC as d I Is Ne eppllmnl Ne sole
le9al w equitable ame(1
n Y� ❑ No
spwse. ifd'�te wuh whom
Is tt�e OroDenY in Guestion: MnuaAy Assessed
❑ Real Rvpenv � amua�N wssessed
M1bdle Florrie (IC 67.
Has Ihis tleduUirn been requested on praprJty
tor arrent yeaf.+ ❑ Yes ❑ I
dumon aGW� h� fhe artnuN of:
20 _ 20 _ 20 20 20 20 2� _
��wre N CountYlweitw Caunry Date (rtmth. daY l��
1 I We certify urWer �he penalry oi perjury that [he above and foregoing infwmation is We and cortect arid that the applitzn[ is a resident of Indiana ard
owner I ton buyer oi ihe aforementioned property on date appiiption is filed. �
�(aWre fslul ma) Date���ry � daY. Yea�
/� f!.:•;•> :. '7._ �
�,�J / 101DV - .. _ ' _ '
Persm aufhw¢ed by dWy exervted Po�uer dAtlomeY � M IC 61.1- .7 � �^b^N. �1%Y��)
Pddress of aWwr'¢ed person (number end sbeet, dry, state, anE LP code) .